November is National Hospice Month – Let’s define hospice

Editor's note: For National Hospice Month, Central New Hampshire VNA & Hospice is providing thoughts honoring the month.

In a recent Dear Annie piece, “Death With Dignity My Way” wondered about choices in end-of-life care and hospice care in particular. She asked “When the obituaries say the person died surrounded by family, did that person have a choice?”

As November is National Hospice Month, and in light of the question posed above, this seems like a good opportunity to talk about Hospice Care – what it is and certainly what it is not. Let’s start with what it is.

Considered to be the model for quality, compassionate care for people facing a life-limiting illness or injury, hospice care involves a team-oriented approach to expert medical care, pain management and emotional or spiritual support expressly tailored to the patient's needs and wishes. Support is provided to the patient's loved ones as well. At the center of hospice and palliative care is the belief that each of us has the right to die pain-free and with dignity and that our families will receive the necessary support to allow us to do so. Though care is primarily based in the home, enabling family members to remain together in peace, comfort, privacy and dignity, care may also be provided in a group home, nursing home or, yes, even in a hospital.

Hospice focuses on caring, not curing. A hospice team includes a Medical Director, skilled nurses, nursing assistants, social workers, spiritual counsel, a bereavement coordinator and volunteers. In many cases, additional disciplines may be added to the patient’s team. The hospice team develops a care plan that meets each patient's individual needs for pain management and symptom control. Care also includes assisting the patient with the emotional, psychosocial and spiritual aspects of dying, provides hospice care related drugs, medical supplies and equipment, coaches the family on how to care for the patient and provides bereavement care and counseling to surviving family and friends for up to 13 months.

Hospice is not a new idea or a fad. In fact, the term “hospice” (from the same linguistic root as the word “hospitality”) can be traced back to medieval times when it referred to a place of shelter and rest for weary or ill travelers on a long journey. The name was first applied to specialized care for dying patients by physician Dame Cicely Saunders, who began her work with the terminally ill in 1948 and eventually went on to create the first modern hospice - St. Christopher’s Hospice - in a residential suburb of London.

Hospice is not for everyone – it must be entered with the full consent and understanding of both the patient and his/her network of support. Hospice is not rigid and does not preach – it allows each patient to define his or her own experience. Hospice is not a “cure” – it is concerned with relieving pain, providing a quality end-of-life experience and providing support.

It is indeed sad that “Death With Dignity” (wherever she lives in the United States) did not seem to receive these services to aid her in the loss of her father, mother and husband. Her grief must be substantial. However, should she choose Hospice Care for herself when the time comes, she should feel assured that the choices are hers and hers alone. A good resource for those seeking information about hospice care is The National Hospice and Palliative Care Organization found on the web at

Locally, Central New Hampshire VNA & Hospice has been providing hospice care for the NH Lakes Region communities for more than 37 years and is able to answer all your hospice related questions as well as direct you to other resources available in the community. You may find them at or by calling 603-524-8444.